Analysis of Outcomes in Open and Laparoscopic Surgeries for Gastric Cancer Patients and Impact of Comorbidity on Differences in Length of Stay and Hospital Costs: Using Healthcare Claims Database

Abstract

Objectives: The aim of this study was to analyze factors affecting the outcomes of gastrectomy in gastric cancer patients, and to identify comorbidities that influence the length of stay and hospital costs differences between open surgeries (OS) and laparoscopic surgeries (LS).Methods: We extracted all health insurance claim data for patients who underwent gastrectomy with gastric cancer as the primary diagnosis from 2019 to 2021, as provided by the Health Insurance Review and Assessment Service in Korea. Univariate analysis was performed to examine differences in general characteristics and distribution of comorbidities between the OS and LS patient groups. Additionally, differences in mean length of stay and mean hospital costs were analyzed. Furthermore, using multivariate analysis, we evaluated factors influencing surgical outcomes. To identify comorbidities contributing to differences in length of stay and hospital costs between the two surgical methods, we compared results from univariate and multivariate analyses for each comorbidity.Results: The multivariate regression analysis of general characteristics revealed that LS had a shorter length of stay and higher hospital costs compared to OS. The analysis of comorbidities, both in univariate and multivariate analyses, consistently indicated that chronic pulmonary disease and peptic ulcer disease were the diseases that caused differences in length of stay and hospital costs between OS and LS.Conclusions: Efforts to consider surgical methods based on patient characteristics and comorbidities are essential to ensure the efficient allocation of medical resources.